NPI | 1831762962 |
---|---|
Former Name | CHELSEA IRENE VIRGIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C016852) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-27386) |
Enumeration Date | 2021-07-16 |
Last Update Date | 2024-05-22 |